With some 400 executives in attendance, the conversations covered a variety of topics, including:

Medicaid work requirements. All five candidates agreed that some form of regulation for able-bodied, safety-net patients in Tennessee was worth exploring. Boyd, the state’s former commissioner of Economic and Community Development, pointed out the costs of monitoring the small number of patients who might qualify for work requirements could outweigh the savings such a program would create.

Block grants. In particular, the three Republican candidates (Boyd, Harwell and Lee) called for more flexibility at the state level, which they said federal block grants would allow. They also said these grants would inspire innovation from the private sector to better meet the health care needs of Tennessee’s workforce. As a business owner, Lee recounted his company’s success in lowering health care spending through incentivizing employees toward more active lifestyles. “I believe changes in behavior only come through incentives,” Lee said. Dean, a former mayor of Nashville, urged caution, saying, “The issue comes down to how big the block grants will be and if the money provided will bring aid to all Tennesseans.”

The role of education in health care. Citing Tennessee’s high rates of chronic illnesses such as diabetes, obesity and cardiovascular disease, candidates offered many solutions based on educating Tennesseans to take ownership of their health. School systems must play a role, said House Minority Leader Fitzhugh, but he also advocated for a broader public awareness campaign. “We have to emphasize it. We have to let people know how bad [the state’s health rankings] really are.”

Opioid epidemic. The candidates offered a range of solutions regarding the opioid epidemic, with many focusing on mental health’s potential role in tackling the issue. Harwell advocated for more drug courts to help divert patients to treatment rather than recycling them through the criminal justice system. “We will not incarcerate our way out of this problem,” Harwell said.

At the forum’s conclusion, Nashville Health Care Council President Hayley Hovious expressed hope that the next Tennessee governor will take advantage of the unique concentration of health care leadership and expertise available to them in Nashville, the nation’s health care capital.

“Nashville, home to a dynamic ecosystem of more than 800 health care companies and service firms, is the epicenter of health care innovation, and we hope to preserve that for years to come,” Hovious said. “It’s clear that this topic is important to all of the candidates, and we look forward to working with the next administration to ensure that Nashville continues to improve patient care across the state and the globe.”

As Middle Tennessee’s largest and fastest-growing employer, the health care industry creates a local economic impact of nearly $40 billion and 250,000 jobs.